Anemia in Pregnancy With CKD

Area of Science:

• Nephrology
• Hematology
• Obstetrics

Background:

• Chronic kidney disease (CKD), anemia, and iron deficiency are significant global health concerns.
• In pregnancy, CKD and iron deficiency anemia elevate risks for adverse maternal and neonatal outcomes.
• The specific contribution of iron deficiency anemia to adverse outcomes in CKD pregnancies remains unclear.

Purpose of the Study:

• To review the pathophysiology of anemia in healthy pregnancy and CKD.
• To evaluate current literature on iron deficiency, anemia, and nutritional deficits in pregnant women with CKD.
• To identify knowledge gaps and propose research priorities for managing anemia in this population.

Main Methods:

• Literature review and synthesis of existing research.
• Evaluation of (patho)physiology of anemia in pregnancy and CKD.
• Identification of knowledge gaps in prevalence, pathophysiology, and treatment.

Main Results:

• Anemia in CKD pregnancy is a complex issue with limited research on iron deficiency's specific impact.
• Current knowledge on the prevalence, pathophysiology, and treatment of iron deficiency and anemia in pregnant women with CKD is insufficient.
• Significant unanswered questions exist regarding optimal management strategies, including oral/IV iron and recombinant human erythropoietin (rhEPO).

Conclusions:

• More research is critically needed to understand and manage anemia in pregnant women with CKD.
• Establishing optimal treatment protocols for iron deficiency and anemia in this high-risk group is a priority.
• Addressing these knowledge gaps will improve maternal and neonatal outcomes.